Posts Tagged ‘adolescents’

Snacking is Bad. Right?

June 12th, 2013

In this uncertain world, one thing we can be sure of is that adolescent snacking is contributing to the obesity epidemic. Right? Well, er, no. Actually, young snackers (you know who you are) are likely to be less obese.

According to a literature review from 2000 to 2011 by Nicole Larson  and Mary Story at the University of Minnesota, “Although snacks can contribute to intake of key nutrients, frequent snacking has been associated with higher intake of total energy and energy from added and total sugars. Assessments in schools and retail stores have further indicated that energy-dense, nutrient-poor snacks are widely available in settings where youth spend their time. The majority of studies either found no evidence of a relationship between snacking behavior and weight status or found evidence indicating that young people who consumed more snacks were less likely to be obese; however, additional research is needed to address various methodological limitations.”

Picture: Selena Gomez snacking. Source:


Improvements Seen in Children’s, Teen’s Diets

February 21st, 2013

Looking for good news? Well, you may need a magnifying glass but it appears caloric intake in American children and adolescents is coming down. In a new report from the CDC, among children and adolescents aged 2–19, caloric intakes decreased for most age groups between 1999–2000 and 2009–2010. According to the report, “Trends in the protein, carbohydrate, and fat intakes were inconsistent. Protein intakes, expressed as a percentage of total kilocalories, increased for all boys and for all girls, and carbohydrate intakes, expressed on the same basis, decreased for all boys and for all girls. However, the observed trends for protein and carbohydrate intakes were not found for all racial and ethnic groups. The percentage of kilocalories from protein increased for all sex and racial and ethnic groups except for non-Hispanic black girls. The percentage of kilocalories from carbohydrate decreased for non-Hispanic white boys and girls and for non-Hispanic black boys, but there was no trend for the other sex and racial and ethnic groups. The only trend in fat intakes was a decrease in saturated fat intakes of Mexican-American boys and girls.

The percentage of calories from protein, carbohydrate, and fat were within the ranges recommended for these macronutrients for this age group, but the percentage of calories from saturated fat was above the 10% recommended in the Dietary Guidelines for Americans, 2010. In 2009–2010, on average, U.S. children and adolescents consumed between 11% and 12% of kilocalories from saturated fat.”


Updated obesity prevalence figures for children and adolescents

September 18th, 2012

NCHS has also updated the prevalence figures for children and adolescents, from 1963-1965 to 2009-2010. Overall, data from NHANES indicate 16.9% of children and adolescents aged 2-19 are obese. Among preschool children aged 2-5,  obesity increased from 5% to 12% between 1976-1980 and 2009-2010. Among children aged 6-11, the prevalence rate increased from 6.5% to 18% and among adolescents aged 12-19 from 5% to 18.4%.



The Picture of Underweight in America

September 18th, 2012

Regarding adults, they report a significant decrease in underweight from an estimated 4% in the early 1960s to 1.7% in 2007-2010. The decrease was significant among all age groups. While the prevalence of underweight is greater among women than men, a significant decline was observed in both genders. Women age 20-39 saw a decrease in prevalence of underweight went from 3% in 1988-1994 to 1.9% in 2007-2008.


Regarding children and adolescents aged 2-19, an estimated 3.5% are underweight, down from 5.1% in 1971-1974. Among children aged 2.5, prevalence dropped from 5.8% to 3.4% from 1971-1974 to 2007-2010; among children 6-11, the rate dropped from 5.3% to 3.6%. No significant change was observed among adolescents aged 12-19.


An interesting observation on underweight has come from a study by Koh and colleagues. They looked at demographic, BMI and related data from the Boston Health Care for the Homeless Program and compared the data on the homeless to the NHANES data. They found that only 1.6% of the homeless adults were underweight. They found that the homeless population weight distribution was basically the same as the general population. They state, “Although underweight has been traditionally associated with homelessness, this study suggests that obesity may be the new malnutrition of the homeless in the United States. PubMed: Koh: The Hunger_Obesity Paradox: Obesity in the Homeless


FDA Approves Once Weekly Drug for Diabetes; Shows Weight Loss

January 28th, 2012

The Food and Drug Administration has approved Amylin Pharmaceutical’s Bydureon for thetreatment of type 2 diabetes. This is the first once-weekly treatment for type 2 diabetes. It is hoped that this feature will lead to higher adherence to the treatment regimen, although as with Byetta, it is injectable. The drug is exenatide, a GLP-1 receptor agonist. Study results showed an improvement in glycemic control.  A1C levels, a measure of blood sugar, decreased an average of 1.6 points.

Many patients with Type 2 diabetes are also overweight or obese. Many drugs for type 2 diabetes actually cause weight gain. The advantage of Bydureon (and its daily administered counterpart, Byetta) is that patients taking Bydureon can achieve weight loss, in addition to improvements in glycemia, blood pressure, and cholesterol in both overweight and obesity subjects with and without type 2 diabetes. Effects of glucagon-like peptide-1 receptor agonists on … [BMJ. 2012] – PubMed – NCBI

A very small study of 12 children and adolescents with extreme obesity also showed significant improvements, suggesting the need for a larger study. Exenatide as a weight-loss therapy i… [Obesity (Silver Spring). 2012] – PubMed – NCBI

More information is available at

Bariatric Surgery for Teens on the Rise

December 27th, 2011

A new study shows a dramatic increase in bariatric surgery for adolescents. The procedures have changed with an increase in gastric banding and a decrease in gastric bypass. Side effects and mortality remain small in this study of academic medical centers. Increasing utilization of laparoscopic gastric bandi… [Am Surg. 2011] – PubMed – NCBI

American Heart Assn. Sees Tidal Wave of Cardiovascular Disease coming from Obesity Epidemic

December 16th, 2011

The American Heart Association has published an update on the burden of cardiovascular disease and stroke. They warn that the recent drop in death rates is likely to be reversed by the continuing increases in the rates of diabetes and obesity. Dr. Donald Lloyd-Jones told MedPageToday  that rising death rates in cardiovascular death in young adults is particularly troubling, “Because if they’re getting disease at this young of an age then they’re just the leading edge – the canaries in the coal mine, if you will – that suggests that we have a whole tidal wave of cardiovascular disease that is coming as a result of the obesity epidemic.” Medical News: Diabetes, Obesity Overshadow Lower CV Death Rate – in Cardiovascular, Prevention from MedPage Today 

Here are the facts:

The estimated prevalence of overweight and obesity in US adults (>20 years of age) is 149 300 000, which represents 67.3% of this group in 2008. Fully 33.7% of US adults are obese (body mass index >30 kg/m2). Men and women of all race/ethnic groups in the population are affected by the epidemic of overweight and obesity.

● Among children 2 to 19 years of age, 31.9% are overweight and obese (which represents 23 500 000 children), and 16.3% are obese (12 000 000 children). Mexican American boys and girls and African American girls are disproportionately affected. Over the past 3 decades, the prevalence of obesity in children 6 to 11 years of age has increased from <4% to more than 20%.

● Obesity (body mass index >30 kg/m2) is associated with marked excess mortality in the US population. Even more notable is the excess morbidity associated with overweight and obesity in terms of risk factor development and incidence of diabetes mellitus, CVD end points (including coronary heart disease, stroke, and heart failure), and numerous other health conditions, including asthma, cancer, degenerative joint disease, and many others.

● The prevalence of diabetes mellitus is increasing dramatically over time, in parallel with the increases in prevalence of overweight and obesity.

● On the basis of NHANES 2003–2006 data, the age adjusted prevalence of metabolic syndrome, a cluster of major cardiovascular risk factors related to overweight/obesity and insulin resistance, is 34% (35.1% among men and 32.6% among women).

● The proportion of youth (<18 years of age) who report engaging in no regular physical activity is high, and the proportion increases with age. In 2007, among adolescents in grades 9 through 12, 29.9% of girls and 17.0% of boys reported that they had not engaged in 60 minutes of moderate-to-vigorous physical activity, defined as any activity that increased heart rate or breathing rate, even once in the previous 7 days, despite recommendations that children engage in such activity >5 days per week.

● Thirty-six percent of adults reported engaging in no vigorous activity (activity that causes heavy sweating and a large increase in breathing or heart rate).

● Data from NHANES indicate that between 1971 and 2004, average total energy consumption among US adults increased by 22% in women (from 1542 to 1886 kcal/d) and by 10% in men (from 2450 to 2693 kcal/d;

● The increases in calories consumed during this time period are attributable primarily to greater average carbohydrate intake, in particular, of starches, refined grains, and sugars. Other specific changes related to increased caloric intake in the United States include larger portion sizes, greater food quantity and calories per meal, and increased consumption of sugar-sweetened beverages, snacks, commercially prepared (especially fast food) meals, and higher energy-density foods.

For the full report, see Heart Disease and Stroke Statistics—2011 Update1. About 1. About These Statistics2. American Heart Association’s 2020 Impact Goals3. Cardiovascular Diseases4. Subclinical Atherosclerosis5. Coronary Heart Disease, Acute Coronary Syndrome, and Angina Pectoris6.

Nation’s Obesity Strategy a Failure

October 7th, 2011

The Department of Health and Human Services has issued its 10 year review of the nation’s health care goals, set in 2000. For obesity the picture is not pretty. By direct measurement between 1988-94 and 2005-8, adults over 20 with obesity increased by nearly 47.8%. The target for 2010 was 15%. Children and adolescent rates increased by 63.5% from 11% to 18%. The 2010 target was 5%.  The report also not little to no progress on increasing the proportion of adults or adolescents engaged in regular vigorous physical activity.  Finally, the proportion of adults 20 and over at a healthy weight, directly measured, decreased by 26%; in 2008 only 31% of American adults were at a health weight, the Healthy People goal was 60%. The proportion of persons with healthy eating habits showed no change, still below targets.

CDC – National Center for Health Statistics Homepage

It has to be recognized that during this period millions of dollars have been spent in the public and private sector on educating the public on obesity and the message to ‘eat less and exercise more’ (ELEM).  One would think that this dismal outcome would encourage a critical reappraisal of the nation’s anti-obesity strategy. Alas, I wish it were so. I suspect that we will see merely a call to shout ELEM louder.